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Open Label Study of Adalimumab in Subjects Who Have a Sub-optimal Response to Systemic Therapy or Phototherapy

8. April 2011 aktualisiert von: Abbott
The objective of this study was to evaluate the safety and efficacy profile of Humira (adalimumab) in patients who had a sub-optimal response to prior systemic therapy. This open-label study was conducted in a patient population of moderate to severe chronic plaque psoriasis patients, which is an approved patient population for adalimumab.

Studienübersicht

Status

Abgeschlossen

Bedingungen

Intervention / Behandlung

Detaillierte Beschreibung

This 16-week multicenter, open-label study was designed to evaluate the efficacy and safety of a loading dose of 80 mg adalimumab, followed by 40 mg adalimumab every other week in the treatment of psoriasis in patients with a sub-optimal response to etanercept, methotrexate (MTX), or Narrow band Ultraviolet - B (NB-UVB).

Approximately 150 participants were planned for 3 sub-studies: 80 participants with sub-optimal response to etanercept, 40 participants with sub-optimal response to MTX, and 30 participants with sub-optimal response to NB-UVB. Actual enrollment was 82 participants with sub-optimal response to etanercept, 41 participants with sub-optimal response to MTX, and 29 participants with sub-optimal response to NB-UVB.

Screening was performed at least 96 hours and no more than 31 days before the Baseline visit (Week 0). A participant who was eligible for the study based on sub-optimal response to one treatment (MTX, NB-UVB, or etanercept) was required to discontinue that treatment within a specified time before first dose of adalimumab (see descriptions of sub-study groups). In addition, if the participant was also receiving another qualifying treatment, he/she was required to have discontinued the other treatment at least 30 days before the Baseline visit (Week 0).

Adalimumab was administered by subcutaneous (SC) injection. At the Baseline Visit (Week 0), all participants received an initial dose of 80 mg adalimumab SC. Every other week (odd-numbered weeks) from Week 1 to Week 15, participants received 40 mg adalimumab SC.

This was a single group assignment study, that is, all participants received the same treatment; however, data were summarized for 3 groups (sub-studies) that were defined by psoriasis treatments participants received before entering this study: methotrexate, etanercept, or narrow-band, ultraviolet-B.

Efficacy was evaluated using the Physician's Global Assessment (PGA) of disease severity, and patient-reported outcomes: Patient's Global Assessment (PTGA) of disease severity, the Psoriasis-related Pruritus Assessment, the Dermatology Life Quality Index (DLQI), a visual analog scale (VAS) for plaque psoriasis and psoriatic arthritis pain, the Medical Outcomes Study (MOS) Sleep Scale, and the Work Productivity and Activity Impairment Questionnaire: Specific Health Problem (WPAI: SHP).

Serious and nonserious adverse events were summarized by sub-study of participants (suboptimal response to MTX, suboptimal response to NB-UVB, and suboptimal response to etanercept).

Studientyp

Interventionell

Einschreibung (Tatsächlich)

152

Phase

  • Phase 3

Kontakte und Standorte

Dieser Abschnitt enthält die Kontaktdaten derjenigen, die die Studie durchführen, und Informationen darüber, wo diese Studie durchgeführt wird.

Studienorte

  • Kanada
    • Alberta
      • Calgary, Alberta, Kanada, T2S 3B3
        • Kirk Barber Research
      • Edmonton, Alberta, Kanada, T5K 1X3
        • Stratica Medical
    • Nova Scotia
      • Halifax, Nova Scotia, Kanada, B3H 1Z4
        • Eastern Canada Cutaneous Research Associates
    • Ontario
      • Hamilton, Ontario, Kanada, L8N 1V6
        • Dermatrials Research
      • Waterloo, Ontario, Kanada, N2J 1C4
        • K.Papp Clinical Research Inc
    • Quebec
      • Montreal, Quebec, Kanada
        • Siena Medical Research
      • Quebec City, Quebec, Kanada, G1V 4X7
        • Centre de Rescherche Dermatologique Du Quebec Metropolitain
  • Vereinigte Staaten
    • Alabama
      • Birmingham, Alabama, Vereinigte Staaten, 35205
        • Total Skin and Beauty Dermatology Centers
    • Arkansas
      • Little Rock, Arkansas, Vereinigte Staaten, 72205
        • Dermatology Research of Arkansas
    • California
      • San Diego, California, Vereinigte Staaten, 92123
        • Therapeutics Clinical Research
    • Florida
      • Miami, Florida, Vereinigte Staaten, 33136
        • Florida Academic Dermatology Centers
    • Georgia
      • Atlanta, Georgia, Vereinigte Staaten, 30327
        • Peachtree Dermatology Associates
    • Indiana
      • Indianapolis, Indiana, Vereinigte Staaten, 46256
        • Dawes Fretzin Clinical Research Group
    • Massachusetts
      • Andover, Massachusetts, Vereinigte Staaten, 01810
        • ORA Clinical Research and Development
    • New York
      • Bronx, New York, Vereinigte Staaten, 10467
        • Montifiore Medical Center
      • New York, New York, Vereinigte Staaten, 10016
        • New York University School of Medicine
      • New York, New York, Vereinigte Staaten, 10029
        • Mount Sinai School of Medicine
    • Pennsylvania
      • Philadelphia, Pennsylvania, Vereinigte Staaten, 19103
        • Paddington Testing Co.
    • Rhode Island
      • Johnston, Rhode Island, Vereinigte Staaten, 02919
        • Clinical Partners
    • South Carolina
      • Greer, South Carolina, Vereinigte Staaten, 29651
        • Radiant Research
    • Texas
      • Dallas, Texas, Vereinigte Staaten, 75246
        • Baylor Research Institute
      • Dallas, Texas, Vereinigte Staaten, 75230
        • Dermatology Treatment & Research Center, PA Research
      • Houston, Texas, Vereinigte Staaten, 77058
        • Center for Clinical Studies
    • Virginia
      • Norfolk, Virginia, Vereinigte Staaten, 23507
        • Virginia Clinical Research, Inc.
    • Washington
      • Seattle, Washington, Vereinigte Staaten, 98101
        • Dermatology Associates

Teilnahmekriterien

Forscher suchen nach Personen, die einer bestimmten Beschreibung entsprechen, die als Auswahlkriterien bezeichnet werden. Einige Beispiele für diese Kriterien sind der allgemeine Gesundheitszustand einer Person oder frühere Behandlungen.

Zulassungskriterien

Studienberechtigtes Alter

18 Jahre und älter (Erwachsene, Älterer Erwachsener)

Akzeptiert gesunde Freiwillige

Nein

Studienberechtigte Geschlechter

Alle

Beschreibung

Inclusion Criteria:

  • Diagnosis of chronic plaque psoriasis with disease duration of at least 6 months
  • Sub-optimal response to treatment with etanercept, methotrexate, or narrow-band UVB phototherapy

Exclusion Criteria:

  • Prior treatment with adalimumab
  • Multiple concomitant therapy restrictions and/or washouts (topicals, ultraviolet, other systemic psoriasis therapies)
  • Prior treatment with natalizumab
  • Concurrent active skin diseases/infections
  • Poorly controlled medical conditions
  • History of neurologic symptoms suggestive of central nervous system (CNS) demyelinating disease
  • History of certain cancers

Studienplan

Dieser Abschnitt enthält Einzelheiten zum Studienplan, einschließlich des Studiendesigns und der Messung der Studieninhalte.

Wie ist die Studie aufgebaut?

Designdetails

  • Hauptzweck: Behandlung
  • Zuteilung: Nicht randomisiert
  • Interventionsmodell: Einzelgruppenzuweisung
  • Maskierung: Keine (Offenes Etikett)

Waffen und Interventionen

Teilnehmergruppe / Arm
Intervention / Behandlung
Experimental: Etikett öffnen
Biologisch: adalimumab
Participants received an 80 mg adalimumab loading dose by subcutaneous injection at Baseline (Week 0). From Week 1 to Week 15, participants received 40 mg adalimumab by subcutaneous injection every other week.
Andere Namen:
  • ABT-D2E7
  • Humira

Was misst die Studie?

Primäre Ergebnismessungen

Ergebnis Maßnahme
Maßnahmenbeschreibung
Zeitfenster
Number of Participants Who Achieved a Physician's Global Assessment (PGA) of Clear (0) or Minimal (1) at Week 16
Zeitfenster: Week 16
The PGA is a 6-point scale used to measure the severity of a patient's disease. Plaque elevation, scaling, and erythema are rated from 0= clear (no plaque elevation; no scaling; erythema=hyperpigmentation, pigmented macules, diffuse faint pink or red coloration) to 5=very severe (plaque elevation=very marked; scaling=very coarse; erythema=very severe [extreme red coloration, dusky to deep red coloration]).
Week 16

Sekundäre Ergebnismessungen

Ergebnis Maßnahme
Maßnahmenbeschreibung
Zeitfenster
Number of Participants Achieving a PGA of Clear (0) at Week 16
Zeitfenster: Week 16
Week 16
Number of Participants Achieving at Least 1 Grade of Improvement in PGA at Week 16 Compared to Screening
Zeitfenster: From Screening to Week 16
From Screening to Week 16
Number of Participants Achieving 0 or 1 on Patient's Global Assessment at Weeks 2, 4, and 8
Zeitfenster: Weeks 2, 4, and 8
The Patient's Global Assessment of Psoriasis-Severity is a rating of how well their disease is controlled. 0=complete disease control; 1=good disease control; 2=limited disease control; 3=uncontrolled disease.
Weeks 2, 4, and 8
Dermatology Life Quality Index (DLQI) Total Score
Zeitfenster: From Screening to Week 4 and Week 16
The DLQI has 10 items and 6 subscales: symptoms and feelings (Q 1 and 2), daily activities (Q 3 and 4), leisure (Q 5 and 6), work and school (Q 7), personal relationships (Q 8 and 9), and treatment (Q 10). Participants rate how much their skin problem affected their life in previous week. Responses are 0 (not at all) to 3=very much. DLQI=total of scores for all items; max=30; min=0.
From Screening to Week 4 and Week 16
Number of Participants Achieving DLQI Total Score of 0 at Week 4 and Week 16
Zeitfenster: Week 4 and Week 16
DLQI total score of 0 indicates psoriasis had no effect at all on participant's life.
Week 4 and Week 16
Psoriasis-related Pruritus Assessment
Zeitfenster: From Screening to Week 16
The Psoriasis-related Pruritus Assessment is a scale for evaluating pruritus-related to psoriasis over the previous week; values range from 0 (no itching) to 10 (severe itching). A decrease in score indicates an improvement in pruritus.
From Screening to Week 16
Visual Analog Scale (VAS) for Pain Involving Psoriatic Plaques and/or Psoriatic Arthritis
Zeitfenster: From Screening to Week 16
The participant rates his/her pain during the previous week on a 100 mm VAS, from 0=no pain to 100=pain as bad as it could be. A decrease in score indicates improvement.
From Screening to Week 16
Percent Work Time Missed Due to Psoriasis
Zeitfenster: From Screening to Week 16
Work and activity impairment due to psoriasis were evaluated using the Work Productivity and Activity Impairment Questionnaire: Specific Health Problem (WPAI-SHP), a 6-item questionnaire that measures effect of psoriasis on number of hours worked and the number of hours missed from work. It also measures the effect on productivity and regular activities: 0=no effect on work/daily activities; 10=psoriasis prevented me from working/doing daily activities. Decreases in values on each part indicate improvement. At Screening, percent time missed in the previous week ranged from 0% to 40%.
From Screening to Week 16
Percent Overall Work Impairment Due to Psoriasis
Zeitfenster: From Screening to Week 16
Percent overall work impairment was evaluated using the Work Productivity and Activity Impairment Questionnaire: Specific Health Problem (WPAI-SHP) (described above). At Screening, overall impairment ranged from 0% to 94%. A decrease in percent overall work impairment indicates improvement.
From Screening to Week 16
Percent Impairment While Working Due to Psoriasis
Zeitfenster: From Screening to Week 16
Percent impairment while working was evaluated using the Work Productivity and Activity Impairment Questionnaire: Specific Health Problem (WPAI-SHP), described above. At Screening, impairment while working ranged from 0% to 90%. A decrease in percent impairment indicates improvement.
From Screening to Week 16
Percent Activity Impairment Due to Psoriasis
Zeitfenster: From Screening to Week 16
Percent impairment in regular activities was evaluated using the Work Productivity and Activity Impairment Questionnaire: Specific Health Problem (WPAI-SHP), described above. At Screening, activity impairment due to psoriasis ranged from 0% to 90%.
From Screening to Week 16
Sleep Problems Index II
Zeitfenster: From Screening to Week 16
Sleep Problems Index of the Sleep Scale from the Medical Outcomes Study reflects sleep disturbance, perceived sleep adequacy, daytime somnolence, and awakening short of breath or with headache. Participant rates each item from "none of the time" to "all of the time" for the previous 4 weeks. Scores are transformed to 0 to 100 scale; lower scores indicate less impairment. Decrease in score indicates improvement.
From Screening to Week 16

Mitarbeiter und Ermittler

Hier finden Sie Personen und Organisationen, die an dieser Studie beteiligt sind.

Sponsor

Abbott

Ermittler

  • Studienleiter: Martin M Okun, M.D., Ph.D., Abbott

Publikationen und hilfreiche Links

Die Bereitstellung dieser Publikationen erfolgt freiwillig durch die für die Eingabe von Informationen über die Studie verantwortliche Person. Diese können sich auf alles beziehen, was mit dem Studium zu tun hat.

Allgemeine Veröffentlichungen

Studienaufzeichnungsdaten

Diese Daten verfolgen den Fortschritt der Übermittlung von Studienaufzeichnungen und zusammenfassenden Ergebnissen an ClinicalTrials.gov. Studienaufzeichnungen und gemeldete Ergebnisse werden von der National Library of Medicine (NLM) überprüft, um sicherzustellen, dass sie bestimmten Qualitätskontrollstandards entsprechen, bevor sie auf der öffentlichen Website veröffentlicht werden.

Haupttermine studieren

Studienbeginn

1. Januar 2008

Primärer Abschluss (Tatsächlich)

1. April 2009

Studienabschluss (Tatsächlich)

1. April 2009

Studienanmeldedaten

Zuerst eingereicht

1. Dezember 2007

Zuerst eingereicht, das die QC-Kriterien erfüllt hat

1. Dezember 2007

Zuerst gepostet (Schätzen)

4. Dezember 2007

Studienaufzeichnungsaktualisierungen

Letztes Update gepostet (Schätzen)

12. April 2011

Letztes eingereichtes Update, das die QC-Kriterien erfüllt

8. April 2011

Zuletzt verifiziert

1. April 2011

Mehr Informationen

Begriffe im Zusammenhang mit dieser Studie

Zusätzliche relevante MeSH-Bedingungen

Andere Studien-ID-Nummern

  • M10-238

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